Medisiner

Medisinfri behandling

Helse- og omsorgsminister Bent Høie har gitt helseregionene pålegg om å tilby personer med psykiske lidelser tilbud om medisinfri behandling. Lite tyder på at ordningen vil nå mennesker med utviklingshemming.

Tilbudet om medisinfri behandling etableres fordi relativt få får positive effekter av medisiner mot psykoser og depresjoner. I følge Paulsrudutvalget (se side 111), har antipsykotika en positiv effekt på 10 - 20%, ut over placebo (se side ). Det vil si at en må behandle fem til ti pasienter for at en pasient får positive effekter av medikasjonen. Blant dem som får positive effekter av behandlingen, er effekten stort sett svært liten. Bivirkningene kan imidlertid være svært store.

Rundt 40% av voksne med utviklingshemming gis medikasjon mot psykoser eller depresjoner, ofte uten at de har diagnose. Få betviler at det pågår en utstrakt medikasjon av mistrivsel og uheldige livsbetingelser. I 2011 uttalte nåværende helsedirektør Bjørn Guldvåg:

– Me manglar kompetanse til å vurdera helsesituasjonen til psykisk utviklingshemma. Me kan sjå at mistrivsle blir feiltolka som psykiatrisk sjukdom.

Innen psykisk helsevern, blir medikasjon av personer som ikke samtykker til behandlingen betraktet som tvangsbehandling. I helse- og omsorgstjenestelovens kapittel 9, om bruk av tvang og makt overfor personer med psykisk utviklingshemming, blir medisinering ikke betraktet som et tvangsvedtak, uavhengig av om pasienten forstår konsekvensene eller ikke.

Det er positivt at helse- og omsorgsminister Bent Høie krever medisinfrie behandlingstilbud innen den tradisjonelle psykiatrien. Det er all grunn til å utvide ordningen til også å omfatte mennesker med utviklingshemming. De fleste som medisineres har ingen psykiatrisk diagnose. Medisinene skrives vanligvis ut av en lege som verken er psykiater eller som har spesiell innsikt i utviklingshemming og utviklingshemmedes levekår. Medikasjonen blir sjelden evaluert.

Mediakasjon av atferdsvansker hos mennesker med utviklingshemming, bør i det lengste unngås. Tilrettelegging av livssituasjonen er oftest en langt bedre medisin. Må en ty til medisiner, bør dette regnes som et tvangstiltak.

Jens Petter Gitlesen

30 januar 2017

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